Erysipelas

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Relatively specific manifestation if group A streptococcal skin infection that is distinguished from cellulitis by intracutaneous edema, palpable margins and peau d’orange changes of the skin.

Is an acute infection typically with a skin rash, usually on any of the legs and toes, face, arms and fingers.

Is an acute infection typically with a skin rash, usually on any of the legs and toes, face, arms and fingers.

An infection of the upper dermis and superficial lymphatics.

Usually caused by Beta-hemolytic group A streptococcus bacteria on scratches or otherwise infected areas.

More superficial than cellulitis, and is typically more raised and demarcated.

An infection of the upper dermis and superficial lymphatics.

Usually caused by Beta-hemolytic group A streptococcus bacteria on scratches or otherwise infected areas.

More superficial than cellulitis, and is typically more raised and demarcated.

Patients typically develop symptoms high fever, shaking, chills, fatigue, headaches, vomiting, and general illness within 48 hours of the initial infection.

The skin lesion enlarges rapidly and has a sharply erythematous demarcated raised edge that appears as a red, swollen, warm, hardened and painful rash.

More severe infections can result in vesicles, blisters, and petechiae with possible skin necrosis.

Lymph nodes may be enlarged, and lymphedema may occur.

Occasionally, a red streak extending to the lymph node can be seen.

The infection may occur on any part of the skin including the face, arms, fingers, legs and toes.

Infection tends to favor the extremities.

Fat tissue is most susceptible to infection.

Facial areas typically involved with fat tissue around the eyes, ears, and cheeks.

Repeated infection of the extremities can lead to chronic swelling.

Most cases of erysipelas due to Streptococcus pyogenes i.e., also known as beta-hemolytic group A streptococci.

Non-group A streptococci can also be the causative agent.

The legs are affected most often.

The rash is due to an exotoxin.

Rash found in areas where no symptoms are present.

Erysipelas infections can enter the skin through minor trauma of any cause, surgical incisions and ulcers.

Can originate from strep bacteria in the subject’s own nasal passages.

Does not affect subcutaneous tissue.

Release serum or serous fluid, but not pus.

The rash is much more well circumscribed and sharply marginated than the rash of cellulitis.

Most common among the elderly, infants, and children.

Risks in patients with immune deficiency, diabetes, alcoholism, skin ulceration, fungal infections and impaired lymphatic drainage.

Diagnosis mainly by the appearance of well-demarcated rash and inflammation.

Blood cultures are unreliable for diagnosis.

Differential diagnosis: cellulitis, herpes zoster, angioedema, and contact dermatitis.

Distinguished from cellulitis by its raised advancing edges and sharp borders.

ASO titter increases by 10 days.

Treatment involves either oral or intravenous antibiotics, using penicillins, clindamycin or erythromycin.

Symptoms resolve in 1-2 days, and the skin may take weeks to return to normal.

May cause bacteremia, including septic arthritis.

Glomerulonephritis can follow from a streptococcal erysipelas or other skin infection.

Can recur in 18–30% of cases even after antibiotic treatment.

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